Provider Demographics
NPI:1144217308
Name:BOREMA, TROY FORD (MD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:FORD
Last Name:BOREMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CHILD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32214
Mailing Address - Country:US
Mailing Address - Phone:904-546-7107
Mailing Address - Fax:904-542-0007
Practice Address - Street 1:964 AJAX ST NBHC JACKSONVILLE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-0001
Practice Address - Country:US
Practice Address - Phone:904-546-7107
Practice Address - Fax:904-542-0007
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 83507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine